Trends in national pharmaceutical expenditure on diabetes in Ireland 2011–2015: a repeated cross-sectional study

Neill, Kate N O’; Bennett, Kathleen; Hugh, Sheena Mc; Fitzgerald, Anthony P.; Kearney, Patricia

doi:10.1136/bmjopen-2020-037382

Cited by 3 publications

(1 citation statement)

References 26 publications

(42 reference statements)

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“…In Ireland, the prevalence of doctor diagnosed diabetes among adults increased from 2.2% to 5.2% between 1998 and 2015 2 . Diabetes and its associated comorbidities and complications [3][4][5][6][7][8] place a significant financial burden on health systems [9][10][11][12][13][14] . In response, most developed countries have reoriented care from episodic management in the acute setting to regular structured management in primary care [15][16][17] , ultimately placing greater responsibility for T2DM management on general practice.…”

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confidence: 99%

Health professionals’ views of the first national GP payment scheme for structured type 2 diabetes care in Ireland: a qualitative study

McGrath¹,

Riordan²,

Kearney³

et al. 2021

HRB Open Res

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Background: Payment schemes are widely used to improve chronic disease management in general practice. Although stakeholder views of such schemes could provide valuable learning regarding aspects that work and those which are more difficult to implement, there is a paucity of such data. We explored health professionals’ views of the implementation of the first national general practice payment scheme for type 2 diabetes (T2DM) care in Ireland, the ‘cycle of care’. Methods: Qualitative data were drawn from a multiple case study evaluating the implementation of a National Clinical Programme for Diabetes, collected from April 2016 to June 2017. Interview and focus group transcripts from participants involved in providing diabetes management in general practice and who referenced the cycle of care were eligible for inclusion in the current analysis. Data were analysed using reflective thematic analysis. Results: We analysed data from 28 participants comprising general practitioners (GPs) (n=8), practice nurses (n=9) and diabetes nurse specialists (DNS) (n=11). Participants perceived the cycle of care as “not adequate, but…a good start” to improve T2DM care in general practice in Ireland. Perceived benefits were greater financial viability for T2DM management in general practice, fostering a more proactive approach to T2DM care, delivery of T2DM care closer to patients’ homes, and increased use of other community diabetes services e.g., DNS and podiatry. Participants identified the limited resource for practice nurse time, inflexibility to provide care based on patient need and issues with data submission as drawbacks of the cycle of care. Conclusions: The cycle of care was viewed as a positive first step to increase and improve T2DM care delivered in general practice in Ireland. The implementation issues identified in this study should be considered in the design of future payment schemes targeting chronic disease management in general practice.

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